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NPI Code Detail

MEDICARE: CITY PARK CARE GROUP LLC

MEDICARE: CITY PARK CARE GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency
2320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1356943658
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITY PARK CARE GROUP LLC
Provider Business Mailing Address
First Line : 1645 GARFIELD ST
Second Line :
City : DENVER
State : CO
Zip : 80206-1914
Country : US
Telephone Number : 720-253-6085
Fax Number :
Provider Business Practice Location Address
First Line : 1645 GARFIELD ST
Second Line :
City : DENVER
State : CO
Zip : 80206-1914
Country : US
Telephone Number : 720-253-6085
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DENISE R VICARIO JUNIK
Credential :
Telephone Number : 720-253-6085
Provider Enumeration Date : 11/11/2020
Last Update Date : 11/11/2020

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Directions to “CITY PARK CARE GROUP LLC ” Practice Location

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